IOM DHSC & MANX CARE

[Banker]

Good summary from Gef, Malone doesn’t come out of this well!!

https://gef.im/2022/05/16/what-will-alf-say/

[quilp]

@Banker Ta for that. It'll be some time before the full effects of the further inquiries into those "troubling issues" is known. If there's evidence of criminality...

Metadata, this administration's Achillies Heel. 

[asitis]

Tomorrow  is Alf Cannans moment to prove whether he is a Chief Minister, or another spineless jellyfish !

[John Wright]

I’ve thought long and hard before posting this. The issue is generating a lot of heat, across several topics.

I’ll try to deal with several questions, separately. Views my own. Not a government shill. Want to try and give some perspective above the baying for blood.

1. Is the E&ET case still sub judice. Well, as usual it’s a split answer. Once a case starts it’s sub judice from that point on until everything is determined. But sub judice doesn’t mean that it can’t be reported or commented upon. Some bits might be sub judice and best avoided and result in contempt proceedings, others not.

So, liability is determined. No appeal or review has been announced. It’s open season for comment and conclusion drawing. But speculation about the remedy and about the evidential questions now to be determined is still covered by sub judice, although it’s hard to see how remedy could be compromised, less so the allegation of failure to disclose and the “faking” of documents put in evidence.

If you’re a politician it’s probably better to avoid those aspects. But expressing a view about the liability finding is OK.

2. Ashford. I have a sympathy for his position. He seems to me to be the victim of the command structure system. It’s a good workable system, properly run and operated with the right people at the right levels. The idea is to focus and funnel the information to the political decision maker so that they aren’t overwhelmed by too much background noise.

Quite who decided Dr Ranson shouldn’t sit on gold, I don’t know. I’d have thought with a situation like covid, and with the competing responsibilities of Ewart, Magson and Ranson ( public health, the health and social care system and medical ) surely all three should have been at the highest level.

Clearly, it’s best if consensus is reached about issues at each level, to be moved up from Bronze, to Silver, to Gold and to the minister & CoMin. It isn’t always possible. That places a duty on the spokesperson or convenor funnelling the info upwards with a duty to highlight areas of dispute, however strong their feelings the other way.

3. political decision making. The scientists and medics can advise all they want. The science doesn’t rule everything. Politicians have to factor in economics, short, medium and long term, plus mental health effects of fortress lock down. 

The truth is there is no right, or wrong answer. But being fed wrong or misleading  information based on personality or disagreement or game playing is not optimal.

My personal view is that short, sharp lock down, much earlier, not just in March 2020, but in September, December/January 2021 and March 2021 would have been better. And backed up by strenuous and consistent testing entrants ( including essential workers and seamen ) before entry, after a few days and after 10/14 days, plus quarantine.

Clearly the sidelining of Ranson in signing off the vaccination programme until the last minute is inexplicable and unforgivable. It was politically inept in its effect on perception. However, given how fast we actually had the vaccination programme delivered I’m not qualified to speculate on effect, adverse or otherwise.

When you have an information filtering system to ensure the best evidence and advice gets to the decision maker(s) it’s not a good idea to allow dissident pathways to spring up. So, I think Ashford was probably correct not to listen to Ranson outside the “system”.

However, the two top doctors, Ewart and Ranson, should have been constantly talking, both within and without the command structure. And then talking to the person in charge of the DHSC, Magson. That fell down. It fell down on Ashford watch. In my view that’s where he has weakness. He was politically responsible for a system that didn’t work in an emergency.

4. Malone. I know Karen. She was deputy CEO in DHSC. Her CEO was not on island, due to her 3 day per week contract being frustrated by covid travel regulations. Wasn’t what she did/was asked to do in reporting to her boss exactly what she was supposed to do?

5. I see Dr Glover has returned. I read everything she posts with respect, but with the caveat that she has an axe to grind, her own disputes and I try and bear that in mind when evaluating. Her testing expertise is unchallenged. We all owe a debt of gratitude. But I can’t make my mind out whether the two big disputes show her in a good light. I partly agree with her, the testing regime should have been more rigorous and consistent. I don’t find myself in agreement about the need for the genotyping to identify strain. I’m still not convinced it would have changed the timing or scope of lockdowns. It’s academically, but not pragmatically or politically important. 

I suspect it’s another personality clash, people within the system not able to agree, or concede. The way she appears to have been treated at one stage appears just as bad as the treatment of Ranson.

When I read her analyses I feel there is a lack of awareness of the political aspect of decision making, and a lack of recognition of the importance of a structured delivery up to the decision maker of the relevant information, which isn’t all or only scientific.

6. My conclusion is simple. Things did go wrong. We ended up with the wrong people, in the wrong places, having the ear of CoMin.

So, Ashford, yes he should resign. Ewart should forward plan leaving/retiring and advertising for her job take place. But Public Health shouldn’t be in cabinet office, or DHSC, but Manx Care. We are after all supposed to be integrating health and care. It’s too late to bring Ranson back in. We now have a Manx Care structure. We need to get on with it. It was born at a time of crisis, not just covid, but the previous failures of DHSC to deliver and of Treasury to adequately fund. It’s making progress. We need stability.

Andy asked which of Ranson & Ewart was senior? Good question. Same level, different disciplines and responsibilities is my view. But with public health semi detached in cabinet office that’s not clear. And wherever PH sits there needs to be a mediation process when/if the two senior medics disagree in future. Presumably the CEO?

 

 

[Hoops]

5 minutes ago, John Wright said:

I’ve thought long and hard before posting this. The issue is generating a lot of heat, across several topics.

I’ll try to deal with several questions, separately. Views my own. Not a government shill. Want to try and give some perspective above the baying for blood.

1. Is the E&ET case still sub judice. Well, as usual it’s a split answer. Once a case starts it’s sub judice from that point on until everything is determined. But sub judice doesn’t mean that it can’t be reported or commented upon. Some bits might be sub judice and best avoided and result in contempt proceedings, others not.

So, liability is determined. No appeal or review has been announced. It’s open season for comment and conclusion drawing. But speculation about the remedy and about the evidential questions now to be determined is still covered by sub judice, although it’s hard to see how remedy could be compromised, less so the allegation of failure to disclose and the “faking” of documents put in evidence.

If you’re a politician it’s probably better to avoid those aspects. But expressing a view about the liability finding is OK.

2. Ashford. I have a sympathy for his position. He seems to me to be the victim of the command structure system. It’s a good workable system, properly run and operated with the right people at the right levels. The idea is to focus and funnel the information to the political decision maker so that they aren’t overwhelmed by too much background noise.

Quite who decided Dr Ranson shouldn’t sit on gold, I don’t know. I’d have thought with a situation like covid, and with the competing responsibilities of Ewart, Magson and Ranson ( public health, the health and social care system and medical ) surely all three should have been at the highest level.

Clearly, it’s best if consensus is reached about issues at each level, to be moved up from Bronze, to Silver, to Gold and to the minister & CoMin. It isn’t always possible. That places a duty on the spokesperson or convenor funnelling the info upwards with a duty to highlight areas of dispute, however strong their feelings the other way.

3. political decision making. The scientists and medics can advise all they want. The science doesn’t rule everything. Politicians have to factor in economics, short, medium and long term, plus mental health effects of fortress lock down. 

The truth is there is no right, or wrong answer. But being fed wrong or misleading  information based on personality or disagreement or game playing is not optimal.

My personal view is that short, sharp lock down, much earlier, not just in March 2020, but in September, December/January 2021 and March 2021 would have been better. And backed up by strenuous and consistent testing entrants ( including essential workers and seamen ) before entry, after a few days and after 10/14 days, plus quarantine.

Clearly the sidelining of Ranson in signing off the vaccination programme until the last minute is inexplicable and unforgivable. It was politically inept in its effect on perception. However, given how fast we actually had the vaccination programme delivered I’m not qualified to speculate on effect, adverse or otherwise.

When you have an information filtering system to ensure the best evidence and advice gets to the decision maker(s) it’s not a good idea to allow dissident pathways to spring up. So, I think Ashford was probably correct not to listen to Ranson outside the “system”.

However, the two top doctors, Ewart and Ranson, should have been constantly talking, both within and without the command structure. And then talking to the person in charge of the DHSC, Magson. That fell down. It fell down on Ashford watch. In my view that’s where he has weakness. He was politically responsible for a system that didn’t work in an emergency.

4. Malone. I know Karen. She was deputy CEO in DHSC. Her CEO was not on island, due to her 3 day per week contract being frustrated by covid travel regulations. Wasn’t what she did/was asked to do in reporting to her boss exactly what she was supposed to do?

5. I see Dr Glover has returned. I read everything she posts with respect, but with the caveat that she has an axe to grind, her own disputes and I try and bear that in mind when evaluating. Her testing expertise is unchallenged. We all owe a debt of gratitude. But I can’t make my mind out whether the two big disputes show her in a good light. I partly agree with her, the testing regime should have been more rigorous and consistent. I don’t find myself in agreement about the need for the genotyping to identify strain. I’m still not convinced it would have changed the timing or scope of lockdowns. It’s academically, but not pragmatically or politically important. 

I suspect it’s another personality clash, people within the system not able to agree, or concede. The way she appears to have been treated at one stage appears just as bad as the treatment of Ranson.

6. My conclusion is simple. Things did go wrong. We ended up with the wrong people, in the wrong places, having the ear of CoMin.

So, Ashford, yes he should resign. Ewart should forward plan leaving/retiring and advertising for her job take place. But Public Health shouldn’t be in cabinet office, or DHSC, but Manx Care. We are after all supposed to be integrating health and care. It’s too late to bring Ranson back in. We now have a Manx Care structure. We need to get on with it. It was born at a time of crisis, not just covid, but the previous failures of DHSC to deliver and of Treasury to adequately fund. It’s making progress. We need stability.

Andy asked which of Ranson & Ewart was senior? Good question. Same level, different disciplines and responsibilities is my view. But with public health semi detached in cabinet office that’s not clear. And wherever PH sits there needs to be a mediation process when/if the two senior medics disagree in future. Presumably the CEO?

 

 

Succinct analysis of this situation, as we would expect. I think though, that this topic is creating heat not only on it's own merits, god knows, but that it seems symptomatic of the general mismanagement and malaise on this island we hold dear. It isn't seen in isolation because it isn't isolated.

[Wavey Davey]

20 minutes ago, John Wright said:

So, Ashford, yes he should resign.

That’s good enough for me. 

[Shake me up Judy]

Sounds very much to me like a criminal investigation should now take place.

[Kopek]

Is it too late to bring Ranson back?

If Cannan were to make it clear that she should be offered the role that would be a clear indication the rot has to stop.

This would be a concocted situation but as Ransons credentials have not been questioned it could be done as a clear sign to others in the Health service that their infighting will not win out?

Trouble is, there have been many years of the medical staff behaving just as badly as the admin?

With the current staff shortage and recruitment problems, how many medics could be cleared out?

Edited May 16, 2022 by Kopek

[John Wright]

4 minutes ago, Kopek said:

Is it too late to bring Ranson back?

If Cannan were to make it clear that she should be offered the role that would be a clear indication the rot has to stop.

This would be a concocted situation but as Ransons credentials have not been questioned it could be done as a clear sign to others in the Health service that their infighting will not win out?

Trouble is, there have been many years or the medical staff behaving just as badly as the admin?

Doesn’t someone else now occupy the role on a substantive basis. So, you’d unfairly dismiss that person?

[Kopek]

I simply mean it could be 'indication' to others in the service that past behaviour is no longer acceptable.

Create a new role of Senior Medical Officer???

[Banker]

9 minutes ago, John Wright said:

Doesn’t someone else now occupy the role on a substantive basis. So, you’d unfairly dismiss that person?

Get rid of Ewart & give Ranson her job! 

[John Wright]

4 minutes ago, Kopek said:

I simply mean it could be 'indication' to others in the service that past behaviour is no longer acceptable.

Create a new role of Senior Medical Officer???

But that would sideline, in part, at the very least, the current post holder. That’s another constructive unfair dismissal case.

Two wrongs don’t make a right.

[John Wright]

1 minute ago, Banker said:

Get rid of Ewart & give Ranson her job! 

She isn’t qualified. Different discipline. 

[forestboy]

If I was her I’d take the money and run. 
would it be tax free?  

[747-400]

11 minutes ago, Kopek said:

I simply mean it could be 'indication' to others in the service that past behaviour is no longer acceptable.

Create a new role of Senior Medical Officer???

Certainly create a senior leadership role for her, allowing her to do what she wanted in cleaning things up. 

There must be enough room for that.